NPI 1003170945

Jaime Lynn Johnson

Practitioner Specialist Bronx, NY

Practice location

Address: 2510 Westchester Ave STE 102, Bronx, NY 10461-3512
Phone: (718) 597-5558

Registered specialties

Specialist Primary

Other Service Providers Taxonomy 174400000X Licence 624934051 (NY)

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Registry record

NPI: 1003170945
Entity type: Individual
Sex (as registered): Female
NPI issued: 26 Jun 2012
Record last updated: 26 Jun 2012

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.